Wandering spleen

Abstract

The spleen is rather firmly attached in the left upper quadrant by five ligaments or peritoneal reflections. With congenital failure or acquired laxity of these attachments, the genital failure or acquired laxity of these attachments, the spleen acquires a true vascular pedicle and becomes mobile. This rare condition, called wandering spleen, makes the organ subject to the complication of torsion, which usually produces an acute abdominal emergency and requires immediate surgical removal. Symptomatic patients display a characteristic constellation of findings that strongly suggests the correct diagnosis and can definitively be ascertained by isotopic imaging specific for the spleen or by ultrasonography. Splenectomy should be performed for all cases of wandering spleen with significant symptoms. A conservative, nonoperative approach in asymptomatic patients is indicated to avoid any chance of postsplenectomy septicemia.